Exploring Malnutrition in Residential Aged Care: A Study on Nursing Notes using Natural Language Processing and Large Language Models

Population ageing has led to an increasing demand for services for the older people. Residential aged care facilities (RACFs) in Australia provide a range of services for older people who can no longer live independently at home. These include accommodation, personal care, health care services and social and emotional support. Despite efforts for comprehensive care, managing nutrition for older people has been complex in RACFs. Malnutrition has emerged as a prevalent issue within these facilities, raising serious health concerns. Therefore, understanding and addressing malnutrition becomes a critical concern for the Australian government. To date, there has been a reliance on nutrition screening tools to assess older people’s nutritional care needs. Conducting these assessments require adequate healthcare training, and is time consuming, thus are not implemented as frequently as needed to timely uncover the risk of malnutrition for older people. In Australia, the majority of RACFs have established electronic health record (EHRs) system to capture and record care recipients’ information. These include medical diagnosis, regular nursing assessment, weight chart, care plan, periodic review, incident and infection review, and nursing progress report. Therefore, RAC EHRs contain wealth of information that can be mined to support aged care services. The advancement in natural language processing (NLP) technologies, in specific, large language models (LLMs), provides an opportunity to uncover useful insight from the RAC EHRs. Therefore, this PhD research is dedicated to extend NLP technology to the under-studied area RAC, design, implement and evaluate LLM applications in nutrition management among older individuals living in RACFs. It aims to design and develop a sophisticated machine learning framework capable of analysing both structured and unstructured EHR data to gain comprehensive insights into the malnutrition issue.